Kinjo T, Mukawa J, Nakata M, Yamashiro K, Tomiyama N, Harakuni T, Shingaki T
Department of Neurosurgery, University of the Ryukyus School of Medicine.
No Shinkei Geka. 1996 Apr;24(4):369-73.
A 20-year-old male patient with tuberous sclerosis was admitted to our hospital complaining of intractable epilepsy. He had been suffering from frequent seizures despite anticonvulsant treatment since the age of 1 year. CT scan and magnetic resonance images showed multiple calcified lesions at the paraventricle and temporal lobe on both sides. Electroencephalogram showed left temporal lobe dominant spike waves. After deep electrodes were inserted into the left amygdala and hippocampus and subdural electrodes were placed on the left temporal cortex, clinical seizures were monitored by video and EEG. The primary focus was found in the amygdala. Left temporal lobectomy was carried out through the cranio-orbital zygomatic approach. Postoperatively, the patient has been seizure-free for one year. Despite multiple intracerebral lesions in tuberous sclerosis, resection of the primary epileptogenic focus is needed to solve the seizure problem if the focus is localized.
一名20岁的结节性硬化症男性患者因顽固性癫痫入住我院。自1岁起,尽管接受了抗惊厥治疗,但他仍频繁发作癫痫。CT扫描和磁共振成像显示双侧脑室旁和颞叶有多个钙化灶。脑电图显示左颞叶为主的棘波。在将深部电极插入左杏仁核和海马体,并将硬膜下电极放置在左颞叶皮质后,通过视频和脑电图监测临床发作情况。发现原发性病灶位于杏仁核。通过颅眶颧入路进行了左颞叶切除术。术后,患者已无癫痫发作一年。尽管结节性硬化症存在多个脑内病变,但如果癫痫病灶定位明确,切除原发性致痫灶对于解决癫痫问题是必要的。